CN105979886B - The sighting device of bone drilling for targeting - Google Patents

The sighting device of bone drilling for targeting Download PDF

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Publication number
CN105979886B
CN105979886B CN201480067647.4A CN201480067647A CN105979886B CN 105979886 B CN105979886 B CN 105979886B CN 201480067647 A CN201480067647 A CN 201480067647A CN 105979886 B CN105979886 B CN 105979886B
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CN
China
Prior art keywords
sighting device
slot
sleeve
positioning device
sighting
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Expired - Fee Related
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CN201480067647.4A
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Chinese (zh)
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CN105979886A (en
Inventor
S.沃夫
T.阿伊比
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DePuy Synthes Products Inc
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DePuy Synthes Products Inc
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Priority claimed from US14/103,338 external-priority patent/US9730711B2/en
Application filed by DePuy Synthes Products Inc filed Critical DePuy Synthes Products Inc
Publication of CN105979886A publication Critical patent/CN105979886A/en
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Publication of CN105979886B publication Critical patent/CN105979886B/en
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17Guides or aligning means for drills, mills, pins or wires
    • A61B17/1728Guides or aligning means for drills, mills, pins or wires for holes for bone plates or plate screws
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17Guides or aligning means for drills, mills, pins or wires
    • A61B17/1721Guides or aligning means for drills, mills, pins or wires for applying pins along or parallel to the axis of the femoral neck

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Dentistry (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

The sighting device that the invention discloses a kind of to drill to targeting into bone, the sighting device includes the slot for extending through sighting device, the slot is configured to receive pilot sleeve at different locations and with different angle wherein, and each of the different angle corresponds to one in the position of the longitudinal extension part of slot.Sighting device can be positioned using positioning device relative to bone plate, which includes base portion, which there is second side from the first side of base portion to base portion to run through its pilot hole extended.The pilot hole is formed elongated hole and is configured to wherein to receive pilot sleeve relative to the different angle of positioning device.

Description

The sighting device of bone drilling for targeting
Technical field
The present invention relates to the technical fields of surgical instruments.In particular it relates to for targeting be bored into bone Sighting device.The invention further relates to the positioning devices for positioning sighting device relative to bone plate, and are related to for being bored into System in bone, which includes sighting device and positioning device, specifically, in conjunction with the bone plate for left and right femur.
Background technique
Bone plate is fixed to consolidating for bone frequently by using suitable tightening member (for example, bone screws, contact pin etc.) by fracture Surely stablized.Often hole is got into lower adjacent bone to be conducive to be inserted into fixing element, such as bone screws, contact pin and other implantation Object.In order to guarantee that osteocomma is securely fixed each other and guarantees that bone plate is fixed firmly to bone, fixing element must accurately determine Position is in bone.Specifically, fixing element is inserted into the angle in bone and is very important.For this purpose, sighting device has been used for More accurately provide the targeting that this some holes is drilled.This sighting device may act as being aligned drill holder along desired bore path Bore template.Sighting device includes through-hole, and drill holder can be for example introduced into the through-hole, and then drilling instrument is drawn The drill bit sleeve was connected for targeting to drill through screw hole.The orientation and bone plate that drill holder passes through the through-hole in sighting device Hole alignment.
The present invention provides the improved sighting device used and drilled to targeting into bone, and for positioning relative to bone plate The correspondence positioning device of sighting device.
Summary of the invention
According to the first aspect of the invention, at least one slot is extended through (positions bone plate and sighting device towards bone In on the bone) first surface and far from bone opposite facing second surface between sighting device.Slot is configured at it In at the different location along the longitudinal extension part of slot with relative to the different angle of longitudinal extension part receive sleeve.Inclination angle Degree, which extends longitudinally portion, to be increased or decreased.In an exemplary embodiment, slot is generally put down with relative to each other Capable surface.
By the way that slot is provided in sighting device, change following angles be it is possible, inserted with the angle by slot The sleeve entered extends through sighting device alternatively, more accurately, extending through the longitudinal extension part of slot.Sleeve is not by securely It is fixed in slot, but can be deviated along the longitudinal extension part of slot to adjust tilt angle, wherein the angle is along the vertical of slot It is increased or decreased to extension.In other words, the angle for being received in the sleeve in slot can be by the longitudinal extension part along slot It deviates sleeve and increases, and can be reduced and deviating sleeve in opposite direction.Preferably, angle can increase or reduce ± 15°.This allows user to select fixing element that will be inserted into the expected angle in bone during operation.
According to exemplary implementation scheme, the inner surface of slot include the sleeve being received in slot is temporarily affixed to it is more The alignment structures at any of a position place, each of the multiple position both corresponds to predetermined axis, edge The predetermined axis can drill.Each of axis passes through slot with different predetermined angles, so that making One in the predetermined angle corresponding to the expected path of bone fixation element insertion may be selected in user.Pilot sleeve is then It can be fixed in selected location to allow reliably to target and be bored into lower adjacent bone.
According to exemplary implementation scheme, alignment structures include a series of grooves being formed in the side of slot, the groove Each of extend along the axis for corresponding to predetermined angle.Alternatively, alignment structures may include extending to A series of ribs in slot, wherein each of described rib is along one 's corresponded in predetermined angle Axis extends.It will also be understood by those skilled in the art that alignment structures may include any group of desired groove and rib Close, or can be used to will to pass through slot insertion pilot sleeve be maintained at its opposite expected angle it is any its His structure.Each feature of alignment structures and the correspondence offer across the expected angle of slot insertion are introduced into slot The specific accurate fixation of sleeve.It is as follows will be described in more detail, the mechanism that sleeve passes through similar ratchet advantageously engage alignment and ties Structure, the component of the similar ratchet allows sleeve mobile by slot, until sleeve reaches the expectation in predetermined angle One.Sleeve is temporarily affixed in selected predetermined angle by the mechanism of similar ratchet, this after sleeve can quilt It is more clamped securely to appropriate location, as described below.Each of each feature in alignment structures is preferably along parallel One linear extension in axis, can drill along the axis.It should be appreciated that alternative alignment structures can be provided that in On the inner surface of slot, the slot includes different characteristic or groove, rib and other features (as long as these features allow Sleeve is fixed with any desired one in angle predetermined in slot) any combination.For example, this knot Structure may include knob, aphylactic map projection or recessed portion.In an exemplary embodiment, these such features of alignment structures Shape corresponds to the shape of the outer surface of sleeve.
According to an exemplary implementation scheme, the axis of alignment structures, which is intersected at, to be selected away from sighting device to bone surface Distance common point at (on the side to bone surface).Preferably, common point is adjacent to the surface of lower adjacent bone.Specifically, public Point can be positioned in the through-hole of corresponding bone plate.This common point forms center, and the set in slot is received around the center Cylinder can be pivoted to change angle of the sleeve relative to sighting device, and therefore change fixing element and be introduced into the introducing in bone Angle.When sleeve is pivoted around common point, it is deviated along the longitudinal extension part of slot, and middle sleeve and the longitudinal of slot extend Angle between portion increases or reduces.
According to an exemplary implementation scheme, sighting device, which is mirrored, to be asymmetrically formed (for example, symmetric around extending through Cross sighting device, be parallel to and the central plane between its first surface and second surface).Specifically, entire to aim at Device can be mirrored and be asymmetrically formed, and preferably reference is parallel to the central plane of first surface and second surface extension and incites somebody to action Sighting device between first surface and second surface is divided into the two halves of two mirror images.In another exemplary embodiment, Only slot can be mirrored and be asymmetrically formed.Pass through the configuration of mirror symmetry, it is possible to use one and identical sighting device with The half side body in the right side and left half side body for patient.For example, single sighting device can be used together for patient with bone plate Right near end of thighbone, and rotate 180 degree then to be used for left femur proximal end.
According to an exemplary implementation scheme, slot has hourglass in the plane perpendicular to first surface and second surface Type or waisted type cross section, and transverse to the longitudinal extension part of slot.As described above, slot can be asymmetrically formed.Hourglass Type waisting type profile allows transverse direction of the sleeve at inclined ramp along slot to be introduced into slot.For example, sleeve can be from taking aim at The mutual opposite surface of standard apparatus is introduced into slot with being inclined by, so that the part of the inner surface of sleeve engagement slot.Showing In example property embodiment, the one or more for the alignment structures that the half that sleeve engages around not more than sleeve perimeter is extended Surface.The side of the engageable only slot of sleeve, for example, the upper area of the inner surface of slot, and the opposite side of slot only Engage the lower area of the inner surface of slot.Therefore, structure may include two mutually independent regions on the inner surface of slot Oppositely to apply sighting device for left and right.Two mutually independent regions can be by the non-adjacent portion shape of the inner surface of slot Extend at, first area from the central plane of first surface towards the sighting device of sighting device, and second area is from aiming The second surface of device extends towards central plane.
It can be overlapped mutually by two according to an exemplary implementation scheme, the slot with above-mentioned hourglass type cross-section Slot is formed, and the slot is parallel to the longitudinal extension part for extending and laterally tilting to along different directions them each other.Two A slot being overlapped mutually can refer to the planar radial extended between first surface and second surface be asymmetrically formed (for example, Symmetric around central plane).This allows left and right oppositely using sighting device, for example, by using left femur and alternatively adopts With right side femur, because therefore sleeve can be introduced into corresponding slot from the two sides of sighting device.
According to another exemplary implementation scheme, sighting device has in the first elongated portion for wherein arranging grooved hole, With in the second elongated portion for being wherein disposed with multiple through-holes.Multiple through-holes can for generic cylindrical and extend through and take aim at Standard apparatus, from the first surface of sighting device to second surface perpendicular to the longitudinal axis of sighting device.Such as the technology of this field Personnel will be understood that through-hole can overlap each other.
In an exemplary embodiment, the first elongated portion and the second elongated portion are extend side by side.Sighting device Each of two elongated portions can extend between corresponding proximal end and distal end, wherein the first elongated portion It is interconnected amongst one another with the proximal end of the second elongated portion.Distal end can be free (that is, not being connected to each other) or same mutual Even.It should be appreciated that the first elongated portion and the second elongated portion can also be arranged to all or any part along total length It interconnects side by side.In an exemplary embodiment, it includes the second of multiple through-holes that the first elongated portion with slot, which is shorter than, Elongated portion.In another exemplary embodiment, first part and second part can be that isometric or second part can It is longer than first part.Slot can substantially take up the total length of the first elongated portion.Multiple through-holes can be generally elongated along second Partial total length distribution.In an exemplary embodiment, through-hole can along the second elongated portion length with rule between Every distribution.
In an exemplary embodiment, the first elongated portion is generally straight, while the second elongated portion is along curved Bent (such as circular arc) extends.Curved shape can correspond to the bending of bone plate, and wherein sighting device is aligned with the bone plate, such as with In the bone plate for the treatment of human femur under loading.Specifically, it should be understood that through-hole can be arranged to correspond to the arrangement of the through-hole of bone plate.
According to another exemplary implementation scheme, sighting device further includes extending through between slot and multiple through-holes Sighting device a part at least another through-hole.At least another through-hole along referring to sighting device first surface and The axially bored line that second surface obliquely extends through sighting device extends.Specifically, it is intended for being used in sighting device In the case where the bone plate of human femur under loading proximal end, which can be disposed in the portions of proximal of sighting device, will The local bone screws to guide prosthese that bone screws are directed in neck of femur or can apply.
According to another aspect of the present invention, positioning device is provided for positioning sighting device relative to bone plate.Positioning dress The base portion set has the first side and opposite second side.The surface of first side, which is shaped as, is attached to bone plate, and can be (for this Kind of purpose) it is non-flat forms, curved, expansion or more waves, as understood by those skilled in the art.Opposite On two sides, i.e., in the base portion side far from bone, sighting device can be coupled on the side.Base portion includes from the first side to second side The pilot hole of the base portion is extended through, which is formed slot and is configured to receive sleeve, i.e., sleeve is with difference Angle is inserted through the slot of sighting device.Term " slot " refers to bigger than its lateral extensions as used herein The elongated slotted apertures of longitudinal extension part.In other words, pilot hole do not have circular cross section and not cylinder.
According to exemplary implementation scheme, pilot hole is tapered along the direction of the first side of the base portion towards bone plate.Pilot hole can For example, funnel type.This shape allows to be introduced into the sleeve in pilot hole and is for example pivoted in pilot hole, with desired Angle relative to positioning device is positioned.
According to an exemplary implementation scheme, the pilot hole in the base portion of positioning device has at least one planar inner wall. Preferably, pilot hole will have that there are two mutually opposite planar inner walls parallel to each other.Sleeve (the set being received in pilot hole Cylinder can be used for example as the pilot sleeve of drill bit or drill holder) it can therefore (limited along a planar inner wall or two planar inner walls In fixed plane) it is conducted through pilot hole.The longitudinal extension part of the slot of sighting device is gone back when it is connected to positioning device It can extend in this plane.
According to an exemplary implementation scheme, positioning device includes the leg extended far from the base portion in second side.It aims at Device connector is formed on leg, preferably on its free end.The length of leg corresponds to sighting device and positioning device The distance between, be conducive to the certain desired angular alignment pilot sleeve relative to sighting device.
Another exemplary implementation scheme includes the pronathous tightening member from the positioning device on the first side.Fastening Element can be rotated relative to base portion positioning device is fastened to bone plate.Tightening member may be, for example, screw (such as annular knurl hair style Screw), which is threadably attached in the respective screw hole in bone plate.However, other tightening members can also be provided, such as Bayonet lock etc..In an exemplary embodiment, positioning device can be connected to bone plate in a manner of peelable, so that positioning device can It is removed after bone plate is fixed on bone.
Another aspect of the present invention is provided for getting by drilling in hole with sighting device and positioning device described above System in bone.System according to exemplary implementation scheme includes above-mentioned sleeve, which preferably has cylindrical outer circle Week.Cylindrical sleeve is used as pilot sleeve to be used for drill bit or other tools, such as drill holder.Sleeve is suitable for extending through The slot of sighting device and the pilot hole of positioning device are crossed to engage the slot and the pilot hole.Sleeve can be filled relative to aiming at Any of the longitudinal extension part for the slot set and multiple predetermined angles of positioning device are located in slot.One In a exemplary implementation scheme, sleeve can be the sleeve-of fluting for example, having at least one slit of the longitudinal direction along sleeve Sleeve, the longitudinal axis which is preferably substantially parallel to sleeve extends-make sleeve can radial compression.
According to another exemplary implementation scheme, system further includes the drill holder for acting on such as drill bit or other tools, The drill bit sleeve has the outer diameter of the internal diameter corresponding to slotted sleeve, so that drill holder can be inserted into slotted sleeve.Fluting Sleeve can change relative to the angle of the longitudinal extension part of the slot of sighting device when slotted sleeve is radially compressed, and It is fixed when drill holder has been inserted into slotted sleeve.Because of the outer diameter of drill holder when slotted sleeve is not in compressed configuration Corresponding to the internal diameter of slotted sleeve, so drill holder, which is introduced into slotted sleeve, prevents slotted sleeve from being compressed and will be slotted Sleeve is fixed in the desired locations in slot.For this purpose, therefore the outer diameter of slotted sleeve is suitable for slot.When slotted sleeve is in slot When in hole along the longitudinal extension part offset of slot, ratcheting operation can be executed by the alignment structures on the inner surface of slot.One Denier drill holder has been introduced into the pilot sleeve of fluting, then the radial compression of pilot sleeve can be prevented from following degree, institute The alignment structures stated on the inner surface that degree is pilot sleeve engagement slot make the pilot sleeve of fluting with predetermined angle Degree is fixed in slot.Firm fixation of the slotted sleeve in slot can therefore on the basis of not other tightening member with Plain mode generates, wherein by the alignment structures of the inner surface of slot (specifically, by the groove wherein formed and/or Rib) predetermined angle position.
According to another exemplary implementation scheme, positioning device has sighting device connector, and sighting device includes Positioning device connector, the sighting device connector and positioning device connector have mutually complementary surface.Sighting device connection Fitting and positioning device connector can be configured to allow along only one be orientated by sighting device installation on the positioning device to prevent Only incorrect connection.For example, positioning device connector can have connector axis, wherein at least the one of positioning device connector A and sighting device connector is asymmetrical relative to the plane by connector axis, so that when using the system to be used for When the left side of body of patient half and right side half, the corresponding correct orientation of only one of sighting device can get.However, identical Fitting structure may be provided in the first surface and second surface of sighting device, so that identical sighting device can be different from being used for The corresponding positioning device of bone plate is used together, such as left femur and right side femur.
According to another exemplary implementation scheme, system offer is mirrored into (for example, mutual mirror image) relative to each other Two positioning devices, with allow that sighting device is fastened to bone plate using a positioning device be used for right side near end of thighbone simultaneously And allow to utilize the positioning device of mirror image for left femur proximal end.Sighting device is preferably mirror symmetry, such as above It is described, and when it for patient body the other half when, can by simply surround sighting device is turned to come with two calmly Position device is used together (for example, rotating about 180 ° of sighting device around its longitudinal axis).Sighting device and two positioning dresses Setting can be provided that in external member, which may also include the pilot sleeve of fluting and one or more different drill holders.
Detailed description of the invention
Following specific embodiments of the previous content of the present invention and exemplary implementation scheme will be easier referring to attached drawing Understand.Exemplary implementation scheme of the invention will be described hereinafter with reference to the accompanying drawings.It should be appreciated that however present patent application not Exemplary implementation scheme shown in being limited to.Attached drawing is shown below:
Fig. 1 shows the sighting device being mounted on bone plate using positioning device in accordance with an exemplary embodiment of the invention Perspective view;
Fig. 2 shows the perspective views of the sighting device of Fig. 1;
Fig. 3 shows another perspective view of the sighting device of Fig. 1;
Fig. 4 shows the top plan view of the sighting device of Fig. 1;
Fig. 5 shows the bottom plan view of the sighting device of Fig. 1;
Fig. 6 shows the side view of the sighting device of Fig. 1;
Fig. 7 shows another side view of the sighting device of Fig. 1;
Fig. 8 shows the perspective view of the positioning device of Fig. 1;
Fig. 9 shows the side view of the positioning device of Fig. 1;
Figure 10 shows the top plan view of the positioning device of Fig. 1;
Figure 11 another exemplary embodiment according to the present invention shows the perspective view of positioning device;
Figure 12 shows the side view of the positioning device of Figure 11;
Figure 13 shows the top plan view of the positioning device of Figure 11;
Figure 14 a shows the first plan view of the positioning device connector of the sighting device of Fig. 1;
Figure 14 b shows the plan view of the sighting device connector of the positioning device of Fig. 8-10;
Figure 15 a shows the second plan view of the positioning device connector of the sighting device of Fig. 1;
Figure 15 b shows the plan view of the sighting device connector of the positioning device of Figure 11-13;
Figure 16 shows the cross-sectional view of the positioning device connector of the sighting device of Fig. 1;
Figure 17 shows the perspective views of the pilot sleeve of the fluting of Fig. 1.
Specific embodiment
It can refer to following specific embodiment and attached drawing and further understand the present invention, wherein similar element is referred to as Drawing reference numeral having the same.Exemplary implementation scheme is related to the sighting device for targeting being bored into bone.Exemplary reality The scheme of applying further relates to the positioning device for being located in sighting device in the desired locations relative to bone plate.Although exemplary reality The scheme of applying describes the sighting device and positioning device for for targeting being bored near end of thighbone, but those skilled in the art It will be understood that sighting device and positioning device of the invention can be similarly used for the targeting drilling of any long bone.
As shown in Figure 1, sighting device 1 can be installed on bone plate 5 using positioning device 2.Sighting device 1 passes through positioning device 2 are aligned with predetermined configuration with bone plate 5, so that sighting device 1 is bored into which can be used for targeting is located bone plate 5 thereon In bone.Cylindrical pilot sleeve 3 can be inserted into the slot 10 of sighting device 1 to guide drill holder 4 to pass through the slot.It can Pilot sleeve 3 is adjusted to be angle of the drill holder 4 relative to sighting device 1 and positioning device 2.Tightening member 6 (for example, Annular knurl hair style screw) it can be used for relative to the fixed sighting device 1 of positioning device 2.
Bone plate 5 (only partially showing) can be the bone plate for patient's left femur proximal end.As discussed further below in detail It is described, by using be configured for right side near end of thighbone positioning device 2', identical sighting device 1 can also be used for patient The bone plate of right side near end of thighbone is used together.Head portion 52 at the proximal end of bone plate 5 including bone plate 5 and from the head The shaft portion 51 that part extends along the direction of the distal end of bone plate 5.Head portion 52 and shaft portion 51, which have, passes through them The through-hole of extension, bone plate 5 can be fixed on bone by the fixing element for receiving fixing element (such as bone screws). Through-hole 50 in the shaft portion 51 of bone plate 5 can be formed such as combination bore, which has compression section and variable-angle Lock part.Through-hole in proximal head part 52 can be hidden by the positioning device 2 in Fig. 1.
As illustrated in figs. 2-7, sighting device 1 can be configured to aim at arm, and the aiming arm includes in an exemplary embodiment First elongated portion 11 and the second elongated portion 13.Sighting device 1 further includes first surface 16 and second surface 17, wherein surface 16 or surface 17 according to present patent application adjacent bone downwards.First elongated portion 11 includes from first surface 16 to second surface 17 The slot 10 of first elongated portion is extended through, for receiving pilot sleeve 3 and drill holder 4.Second elongated portion 13 Through-hole 12 including passing through multiple generic cylindricals that the second elongated portion extends from first surface 16 to second surface 17.When When sighting device 1 is installed to bone plate 5, cylindrical hole 12 is aligned with the through-hole 50 of the shaft portion 51 of bone plate 5, so that insertion is worn The drill holder for crossing through-hole 12 can be used for being bored into the bone being aligned with the through-hole 50 of bone plate 5.Sighting device 1, which may also include, to be used for Sighting device 1 is connected to the positioning device connector 15 of positioning device 2, it will be as described in more detail below.
Shown in the dotted line for passing through pilot sleeve such as Fig. 1, pilot sleeve 3 can be relative to multiple walk-off angles of sighting device 1 Degree is received in the slot 10 of sighting device 1.When pilot sleeve 4 is inserted into slot 10, pilot sleeve 3 passes through positioning The pilot hole 22 (referring to Figure 10) of device 2, the pilot hole are also formed as slot, so that pilot sleeve 3 can be in the pilot hole 22 Interior movement.In an exemplary embodiment, for introducing the bigelow's septum screw of bigelow's septum of femur, pilot sleeve 3 can be used for Drill through hole to targeting.
As shown in Figure 2-5, slot 10 can be limited by the alignment structures 34,35 extended along its inner surface.Alignment structures 34, 35 can form along the opposite inner face of such as slot 10 respectively.Preferably, alignment structures 34,35 include extending to along following axis Groove or rib in slot 10, the axis extend along the direction of predetermined angle, and pilot sleeve 3 is true in advance along this Fixed angular alignment.In another exemplary embodiment, alignment structures 34, each of 35 axis intersect at public At point, which is located at the distance on the side on the surface 17 away from sighting device 1 or the surface 16 towards bone.Specifically Ground, common point can be positioned near the bone surface below pilot hole 22 or be positioned when sighting device 1 is installed to bone plate 5 In the pilot hole 22 of device 2.In the case where the axis of alignment structures 34 35 intersects at common point, it is inserted into slot 10 Pilot sleeve 3 can be moved by pivoting pilot sleeve around common point along the longitudinal extension part of slot 10.However, alignment structures 34,35 axis does not need to intersect at common point.The axis of alignment structures 34,35 extends along the inner surface of slot 10 with correspondence The desired orientation in slot 10 and pilot hole 22 is received in pilot sleeve 3.
The size and shape of pilot sleeve 3 are configured to be formed ratchet mechanism together with the alignment knot on the inner surface of slot 10 Structure 34,35.Pilot sleeve 3 fasten to by alignment structures 34,35 limit relative to sighting device 1 in predetermined angle Either one or two of position in.As shown in figure 17, pilot sleeve 3 includes the axial slots 30 so that 3 radial compression of pilot sleeve, is made Pilot sleeve 3 when its between the protruding portion of alignment structures 34,35 across when can be compressed, and then stretch to fasten to In position in the expandable part of slot 10 corresponding to each expected angle in expected angle, so that pilot sleeve 3 is at it Between move and keep discrete location in slot 10 in a manner of ratchet type.The distal end 33 of pilot sleeve 3 passes through slot 10 And enter in the pilot hole 22 of positioning device 2, so that slit 30 is positioned in the region of slot 10 of sighting device 1.Outside Section doctor or other users then can be with ratcheting manners in 10 bias internal pilot sleeve 3 of slot.The outer diameter of drill holder 4 is selected It is selected to be consistent with the extension internal diameter of pilot sleeve 3, so that pilot sleeve 3 is consolidated when drill holder 4 is introduced into pilot sleeve 3 The desired locations and angle being scheduled in slot 10, such pilot sleeve 3 can be no longer radially compressed into alignment structures 34,35 Protruding portion between move.As shown in Figure 6 and as shown in scale 38, between pilot sleeve 3 and the longitudinal extension part of slot 10 At most 15 ° of variable-angleization.However, it will be appreciated by those skilled in the art that slot 10 can also have at most 20 ° or at most 25 ° or even up to 30 ° of bigger angle change, wherein the angle is relative to vertical axis, (vertical axis is opposite Extended vertically in two sighting device surfaces 16,17) 0 ° is preferably started with, but also start from example in applicable situation Such as -5 ° or -10 °.
As shown in Fig. 2 to 7, sighting device 1 is referring to the central plane extended between first surface 16 and second surface 17 It can be made into mirror symmetry.In other words, sighting device 1 is symmetrical around central plane, which is parallel to the One surface and second surface 16,17 and extend before them.In this way, by the way that sighting device 1 is simple around its longitudinal axis It singly rotating 180 ° and utilizes positioning device 2, sighting device 1 is installed to bone plate by the corresponding positioning device in 2', Sighting device 1 can be used together with the bone plate for left femur proximal end and the bone plate for right side near end of thighbone.Specifically, The slot 10 of this embodiment is mirror symmetry referring to central plane.Therefore, the slot that slot 10 is superimposed by two is formed, So that pilot sleeve 3 can be directed through sighting device 1 and be introduced into calmly from first surface 16 and from opposite facing surface 17 In the correspondence pilot hole 22,22' of position device 2,2'.
Referring to Fig. 1 to Fig. 5, the alignment structures 34,35 on the inner surface of slot 10 include two mutually independent regions 34a, 34b and 35a, 35b.It is led it means that generally only region 34a, 34b are engaged during using sighting device 1 from side To sleeve 3, at the same pilot sleeve 3 in mirror image using the only region 35a generally with alignment structures 34,35 when sighting device 1, 35b engagement.The region 34a of alignment structures, 34b preferably take up the generally half of the inner surface of slot 10, same to time domain 34b, 35b occupy the other half.In other words, from the point of the region separated region 35a and 35ba 34a and 34b away from first surface and Each of two surfaces 16,17 are generally equidistant.Region 34a, 34b include from the surface of sighting device 1 16 along central plane The part 34a that extends of direction, and be located on opposite side, from central plane to sighting device referring to the lateral extensions of slot 10 The part 34b that 1 surface 17 extends.The two parts 34a, 34b of structure are not adjacent, but are pair around central plane Claim, so that the pilot sleeve 3 being received in slot 10 engages a part 34a and slot for the structure 34 on the side of slot 10 Another part 34b of structure on the other side in hole 10.When using sighting device 1, the region 35a of structure 35,35b are same In this way, vice versa.Because pilot sleeve 3 is along being moveable relative to the inclined plane of sighting device 1, it is possible that be Two mutually independent region 34a, 34b and 35a of structure, 35b, the mutually independent area are provided on the inner surface of slot 10 Domain allows left and right is lateral to apply sighting device 1 on the contrary.When planar observation of the edge perpendicular to the surface 16,17 of sighting device 1, Therefore hourglass type cross-section can be had by being formed by slot 10.
As described above, sighting device 1 includes the first elongated portion 11 and the second elongated portion 13.First elongated portion 11 tool There are proximal end 37 and distal end 36.Second elongated portion 13 has proximal end 19 and distal end 18.Two elongate portions Divide 11,13 can interconnect at their proximal end 37,19.In an exemplary embodiment, distal end 36,18 is freely - that is, distal end 36,18 is not connected directly to one another.Two elongated portions 11,13 can along sighting device 1 longitudinal axis simultaneously Row extends, and in an exemplary embodiment, is substantially parallel to and extends each other along common plane.
Sighting device 1 further includes the through-hole for passing through sighting device from first surface 16 to second surface 17 and obliquely extending 14.Through-hole 14 can extend across the proximal end for being separately connected the first elongated portion and the second elongated portion 11,13 of sighting device 1 The part in portion 37,19.The size and shape of through-hole 14 can for example be configured to receive the drill holder for drilling with targeting, with For bone screws being placed in the portions of proximal (specifically, neck of femur) of femur.
Fig. 8 to 10, which is shown, to be configured to determine with what the bone plate 5 for left femur proximal end as shown in Figure 1 was used together Position device 2.Figure 11 to 13 shows the positioning device 2 ' for being configured to be used together with the bone plate for right side near end of thighbone.It is fixed Position device 2,2 ' relative to each other can for mirror image-for example mutual mirror image.
The positioning device 2 of bone plate for left femur proximal end has base portion 20, which is using and therefore forming Period has the surface 23 of adjacent bone plate 5.In other words, surface 23 is non-flat forms, but is, for example, according to the shape of bone plate 5 It is protrusion, curved or awave.Leg 21 extends from the opposite side of base portion 20 24 and includes aiming at dress in its end Set connector 25.The length of leg 21 correspond to 1 astragalus plate 5 of sighting device desired distance, pilot sleeve 3 extend through this away from From.Positioning device 2 can be for example, by being secured to bone plate 5 from the screw 26 outstanding of surface 23, to engage the correspondence screw thread of bone plate 5 Hole.It should be appreciated that other tightening members can also be used to positioning device 2 being fastened to bone plate, such as bayonet lock etc..
As shown in Figure 10, the pilot hole 22 in the base portion 20 of positioning device 2 can be formed slot.In other words, it is oriented to Hole 22 does not have a circular cross section, but along its longitudinal axis be it is elongated-that is, the longitudinal extension part of pilot hole is greater than its transverse direction Extension.In conjunction with sighting device 1 as described above, pilot sleeve 3 and its distal end 33 are concomitantly introduced into pilot hole 22, and Since the shape of pilot hole 22 is moveable therebetween.By the mobile guide sleeve 3 in pilot hole 22, base portion 20 and guiding Variable-angle between sleeve 3.Specifically, since pilot sleeve 3 can be in the slot 10 of sighting device 1 in a manner of ratchet type In plane the generallyperpendicular opposite inner face across first surface and second surface 16,17 and positioned at slot 10 It is mobile, therefore pilot hole 22 has at least one planar inner wall, and in the present embodiment, it is therefore preferred to have two are flat interior Wall, pilot sleeve 3 can be moved along the planar inner wall.
It is same case for the positioning device 2' of mirror image.The positioning device 2' of bone plate for right side near end of thighbone With base portion 20', which has the surface 23' of the adjacent bones plate during using and therefore forming.In other words, surface 23' is non-flat forms, but is, for example, protrusion, curved or awave according to the shape of bone plate.Leg 21' is from base portion The opposite side 24' of 20' extends and includes sighting device connector 25' in its end.The length of leg 21', which corresponds to, aims at dress The distance of 1 astragalus plate 5 is set, pilot sleeve 3 extends through the distance.Positioning device 2' can be for example, by outstanding from surface 23' Screw 26' is secured to bone plate, to engage the correspondence threaded hole of bone plate 5.It should be appreciated that other tightening members can also be used to determine Position device 2' is fastened to bone plate, such as bayonet lock etc..
As shown in figure 13, the pilot hole 22' in the base portion 20' of positioning device 2' can be formed slot, it is meant that it is not With circular cross section, but it is the elongated hole with the longitudinal extension part for being greater than its lateral extensions.Such as in conjunction with sighting device 1 Upper described, pilot sleeve 3 and its distal end 33 are concomitantly introduced into pilot hole 22', and since the shape of pilot hole 22' exists It is therebetween moveable.By the mobile guide sleeve 3 in pilot hole 22', the angle between base portion 20' and pilot sleeve 3 can Variation.Specifically, because passing through the pilot sleeve 3 of the slot 10 of sighting device 1 relative to first surface and second surface 16, 17 and between the opposite inner surface of slot 10 in the plane of generallyperpendicular extension be it is moveable, so pilot hole 22' has at least one planar inner wall along the direction of removable pilot sleeve 3 again.
Figure 14 a shows the first surface 16 of sighting device 1, to show the positioning device suitable for such as left side configuration The part of connector 15.As shown in figures 14a, sighting device 1 includes positioning device connector 15, which is showing It include the insertion piece 40 being inserted into the opening of sighting device 1 in example property embodiment.In an exemplary embodiment, it is inserted into Part 40 is formed by metal, however sighting device 1 is preferably formed by plastics (for example, PEEK).However, insertion piece 40 can also be by shape As across the part for the positioning device 2 being integrally formed therewith.Positioning device connector 15 is formed so that positioning device 2 only It is oriented to along expectation fixable.Specifically, this prevents from sighting device 1 to be mounted to along the orientation for being intended for left half body being intended to For the positioning device 2' of the right half body of patient, vice versa.Preferably, positioning device connector 15 is thus referring to across connection The plane of part axis be it is asymmetrical, the connector axis is extended through perpendicular to sighting device 1 in an exemplary embodiment Surface 16,17 insertion piece 40.For this purpose, pin 45 or other adjustment elements are projected into the opening of insertion piece 40, it is fixed to engage The correspondence recessed portion 44 of the sighting device connector 25 of position device 2 and the installation for preventing mistake.With regard to sighting device 1 referring to positioning For the more Accurate align of device 2, positioning device connector 15 includes recessed portion 41, which engages aiming dress herein Set the pin 43 of connector 25 (referring to Figure 14 b).By tightening on face of the annular knurl hair style screw 6 to engage sighting device connector 25 Threaded hole, pin 43 is drawn into recessed portion 41, and sighting device 1 is fixed along correct orientation.The axis and recess of pin 45 The axis in portion 41 can offset from each other (such as 35 °).Pin 45 preferably projects through the main body of sighting device 1 and passes through insertion piece 40, so that insertion piece 40 is directed to the unexpected rotation relative to the main body of sighting device 1 and fixes.As long as should be appreciated that connection Part provides the keying alignment, then other of sighting device connector 25 and positioning device connector 15 are configured as possibility 's.
Figure 15 a shows sighting device 1 from the opposite side of sighting device 1 17, to show suitable for such as right side configuration Positioning device connector 15 part.Insertion piece 40 has corresponding recessed portion 42, recessed portion engagement positioning on this side The pin 43 of the sighting device connector 25' of device 2' (referring to Figure 15 b).In other respects, therefore application combines Figure 14 a, 14b system The mark of work.
Therefore, an exemplary implementation scheme according to the present invention, system include the positioning device 2 for left side and are used for The mirror image positioning device 2' on right side, but (that is, symmetric around central plane) only one for being formed as mirror symmetry aims at Device 1 is used together by rotating 180 ° around its longitudinal axis with two positioning device 2,2'.
Although reference patient left and right side near end of thighbone describes preferred embodiment, those skilled in the art It will be understood that the principle of the present invention can also be applied to sighting device and positioning device for other bones.For example, the system is also It can be used for distal femur, shin bone or other long bones.It should be appreciated that not departing from original of the invention according to the case of present patent application Under the premise of reason, the shape and size of sighting device and positioning device can be suitable.
For a person skilled in the art it is evident that, without departing from the scope of the present invention, Various modifications and variations can be carried out in structures and methods of the invention.It is therefore intended that the present invention covers of the invention repair Change and modification, precondition be they within the scope of the appended claims and their equivalents.

Claims (20)

1. a kind of sighting device (1) for drilling to targeting into bone, including first surface (16) and opposite facing second table Face (17),
Wherein exist from the first surface (16) to the second surface (17) and extends through the sighting device (1) at least One slot (10), the slot are configured at different locations and with the longitudinal extension part relative to the slot (10) Different angle receives sleeve (3) along the longitudinal extension part of the slot (10), wherein the angle increases along the longitudinal extension part Big or reduction,
Wherein the slot (10) has inner surface, and the inner surface has structure (34,35), and the structure allows to be received in Sleeve (3) in the slot (10) is fixed at the different location at least one predetermined angle,
Wherein the axis of each of described structure (34,35) intersects at common point, and the common point is located to be taken aim at away from described Standard apparatus (1) on the side of the first surface or second surface (16,17) at a distance, and
Wherein when the sighting device is installed to bone plate, the common point is positioned near the surface of the bone.
2. sighting device according to claim 1, wherein the structure (34,35) includes along the predetermined angle The groove or rib that the direction of degree extends.
3. sighting device according to claim 2, wherein the groove or rib and the public point alignment.
4. sighting device according to claim 1, wherein the different angle is changed to mostly 15 ° relative to each other.
5. sighting device according to claim 1, including the slot (10) or the institute of at least described slot (10) It states sighting device (1) and is mirrored symmetrical landform referring to the plane extended between the first surface and second surface (16,17) At.
6. sighting device according to claim 1, wherein the slot (10) is perpendicular to the first surface and second There is hourglass type cross-section in the plane on surface (16,17).
7. sighting device according to claim 1, wherein at least one described slot (10) includes two and is overlapped mutually Slot, described two slots being overlapped mutually, which are parallel to, to be extended each other and longitudinally extends along different directions lateral inclination to it Portion.
8. sighting device according to claim 1, wherein the sighting device (1) includes that the slot (10) is arranged in it In the second elongated portion (13) for being disposed therein of the first elongated portion (11) and multiple through-holes (12).
9. sighting device according to claim 8, wherein first elongated portion and the second elongated portion (11,13) It is extend side by side and is respectively provided with proximal end (37,19) and distal end (36,18), wherein the proximal end (37, 19) it interconnects.
10. sighting device according to claim 8, wherein first elongated portion (11) is along linear extension.
11. sighting device according to claim 8, wherein second elongated portion (13) arc extend.
12. sighting device according to claim 8, including between the slot (10) and the multiple through-hole (12) At least one other through-hole (14) with axially bored line, the axially bored line referring to the sighting device (1) described first Surface and second surface (16,17) obliquely extend through the sighting device (1).
13. sighting device according to any one of claim 1 to 12, wherein the size of the sighting device (1) is set It is calculated as the bone plate (5) that engagement is used for human femur under loading proximal end.
14. a kind of system for drilling into bone, comprising:
Sighting device according to any one of claim 1 to 13, and
For positioning the positioning device (2,2') of the sighting device (1) relative to bone plate (5), the positioning device includes:
Base portion (20,20'), the base portion have its surface be formed for limiting it is adjacent bone plate (5) the first side (23, 23') and the opposite second side (24,24') that can be disposed thereon of the sighting device (1), and
Pilot hole (22,22'), the pilot hole penetrate the base portion from first side to described second side (23,24) (20,20'), the pilot hole are formed slot and are configured to receive sleeve (3) with different angle.
15. system according to claim 14, including slotted sleeve (3).
16. system according to claim 15, wherein the slotted sleeve (3) is adapted to extend through and engages described take aim at The slot (10) of standard apparatus (1) and the pilot hole (22,22') of the positioning device (2,2'), wherein the slotted sleeve (3) Can relative to the slot (10) of the sighting device (1) longitudinal extension part and relative to the positioning device (2,2') Different angle is presented.
17. system according to claim 15, including the drill holder (4) with outer diameter, the outer diameter corresponds to described The internal diameter (31) of slotted sleeve (3), wherein the drill holder (4) can be introduced into the slotted sleeve (3).
18. system according to claim 17, wherein slot of the slotted sleeve (3) relative to the sighting device (1) The angle of the longitudinal extension part in hole (10) can change when the slotted sleeve (3) is radially compressed, and in the drill bit The outer diameter of sleeve (4) is fixed when being introduced into the internal diameter (31) of the slotted sleeve (3).
19. system according to claim 14, wherein the positioning device (2,2') have sighting device connector (25, 25'), and the sighting device (1) has positioning device connector (15), the sighting device connector and positioning device connection Fitting has mutually complementary surface, wherein the positioning device connector (15) has connector axis and reference passes through institute The plane for stating connector axis is not mirror symmetry, so that the sighting device (1) is taken aim at along predetermined orientation from described The side of the first surface and second surface (16,17) of standard apparatus (1) can be separately fixed on the positioning device (2,2').
20. system described in any one of 4 to 19 according to claim 1, including being mirror image relative to the positioning device (2) Positioning device (2'), to make it possible to utilize the positioning device (2) that the sighting device (1) is fastened on for patient's On the bone plate (5) of left femur proximal end, and (2') the sighting device (1) is fastened on using the positioning device of the mirror image The bone plate (5) of right side near end of thighbone for patient.
CN201480067647.4A 2013-12-11 2014-11-24 The sighting device of bone drilling for targeting Expired - Fee Related CN105979886B (en)

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US201361914563P 2013-12-11 2013-12-11
US61/914563 2013-12-11
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US14/103,338 US9730711B2 (en) 2013-12-11 2013-12-11 Aiming device for targeted drilling of bone
PCT/US2014/067102 WO2015088759A1 (en) 2013-12-11 2014-11-24 Aiming device for targeted drilling of bone

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